But the strength of the antibiotic ceftiofur — and the frequency with which it’s being misused on farms across America — has created a threat to human health that may overshadow the drug’s effectiveness, a Reuters examination shows.

The U.S. Food and Drug Administration cautioned in 2012 that ceftiofur could pose a “high public health risk,” in part because the drug belongs to a class of antibiotics considered critically important in human medicine. The warning is the FDA’s strongest kind. The concern is that ceftiofur in animals could spawn antibiotic-resistant bacteria, superbugs that can infect people and defeat conventional medical treatment, even when the drug is used as directed.

A Reuters analysis of government data indicates that the risks to human health may be more significant than previously known. Since last year, records kept by the U.S. Department of Agriculture show that traces of ceftiofur were found at illegal levels in slaughtered animals more frequently than with any other drug. In 2013, ceftiofur alone accounted for one-fourth of all residue violations logged by the USDA, the data show.

The ceftiofur residues are not themselves considered dangerous to people if ingested, because the government sets its standards well below hazardous levels.

But the traces serve as a warning sign that the drug was used shortly before the animal was killed, thus increasing the chances that the meat contains superbugs, said Guy Loneragan, a veterinary epidemiologist at Texas Tech University. Studies show that ceftiofur, more than most other drugs, can sharply increase the amount of antibiotic-resistant bacteria in an animal.

“It kills off weaker bugs and allows stronger ones to survive and multiply,” Loneragan said. The effect is especially pronounced soon after the drug has been used, studies show.

Zoetis says ceftiofur is safe to use as directed. “The use of ceftiofur continues to be appropriate when used according to the label directions in those animals that are in at-risk situations,” said Scott Brown, vice president of global therapeutics research at Zoetis.

The stakes are especially high because the drug is part of a crucial class of antibiotics called cephalosporins. The class includes ceftriaxone, a drug that’s vital to treating pneumonia, meningitis and salmonella infections in children, according to the FDA. The use of one type of cephalosporin can compromise the effectiveness of others in the same class.

“There is a very clear link between ceftiofur use and ceftriaxone resistance,” said Paul Fey, a professor of microbiology at University of Nebraska Medical Center. “We know that ceftiofur-resistant salmonella are clearly ceftriaxone-resistant.”

Economic incentives

Despite the perils, there are economic incentives to misuse ceftiofur. The potent drug can keep a sick cow alive long enough for a dairy farmer to sell the animal to a slaughterhouse. A course of treatment can cost from $20 to more than $100, relatively high for veterinary antibiotics. But that is far less than what the farmer stands to make if the animal survives until it can be sold for meat. Dairy cows for slaughter are now fetching $1,500 or more, according to farmers and USDA data.

Hugh Byron ran a dairy farm in Hillsboro, Kentucky, until 2011 and kept cattle until this year. He says he frequently used ceftiofur to treat common infections in his cows. In July 2010, a dairy cow sent to slaughter from Byron’s farm tested positive for 5.61 milligrams of ceftiofur residue per kilogram of tissue sample. That was 14 times higher than the 0.4 mg/kg tolerance level set by the FDA.

Byron admits that he has administered ceftiofur at the end of his animals’ lives hoping they’d hang on, so that a slaughterhouse would accept the cows and pay him.

“We’re talking about our livelihood, our money. We’re trying to save the cow and if we can’t save the cow, we’re trying to salvage it,” said Byron. “In other words, send her to the stockyard and get something out of it. So there’s a temptation to fudge on it.”

Zoetis features the drug’s economic advantages in its marketing to farmers and veterinarians. One of ceftiofur’s features is a short withdrawal period — the FDA-mandated time between when an animal stops taking an antibiotic and when its milk or meat is certain to be sufficiently free of residue to pass inspection.

The drug’s time advantage is significant. In the case of milk, if a cow takes penicillin, the farmer must discard all the milk produced for at least two days and as many as 15 days after the drug is last given. There’s often no withdrawal period for certain ceftiofur products, so a cow can keep producing milk while taking it.

“No wasted milk ensures a better return on investment,” Zoetis says on its website about its ceftiofur-brand drug Excenel.

The withdrawal period

The residue-testing program is supposed to help the government ensure that farmers are not misusing the drugs. The regulations contain a gap, however. The USDA tests animals for traces of antibiotics, to prevent excess levels of drugs such as ceftiofur from entering the food supply. But the residue program doesn’t test for the presence of resistant bacteria. In the case of ceftiofur, those bugs can survive in an animal past the end of the drug’s required withdrawal period, studies show.

Loneragan of Texas Tech said his research suggests the FDA should analyze whether high levels of resistant bacteria remain beyond the withdrawal period. A longer period may be warranted, he said, to ensure that the resistant bacteria population is reduced before the animal is slaughtered.

The reason for the rise in ceftiofur violations isn’t clear. The USDA implemented a new test in 2012 that it says is better at identifying traces of all drugs. But the USDA residue data don’t show as large an increase in violations for penicillin and other antibiotics as they do for ceftiofur.

FDA spokeswoman Juli Putnam said the agency “is aware of the increase in ceftiofur residue violations” and is gathering more information to “better understand the matter.” She said the agency is aware of Loneragan’s research findings as well, “and we continue to consider the evolving science related to the impact of antimicrobial use on bacterial populations.”

Zoetis said the FDA has evaluated ceftiofur’s impact on antibiotic resistance in bacteria and has approved drugs containing the compound as recently as last year.

Those caught misusing veterinary antibiotics face light consequences. Penalties include condemnation of the animal. FDA inspectors review a violator’s practices, which can result in warning letters ordering farmers to change how they administer the medicines. Further action is extremely rare, an examination of regulatory and court records shows.

The residue testing program has been harshly criticized by federal auditors. A 2010 report by the Government Accountability Office found that the program “is not accomplishing its mission of monitoring the food supply for harmful residues.” One result of the audit was the implementation two years later of the new residue testing methodology now used by the USDA and FDA.

Successful drug

The widespread application of antibiotics in veterinary medicine poses enormous challenges for health authorities. Today, 80 per cent of all antibiotics used in the U.S. are given to livestock, not to people. In September, Reuters documented how some of America’s largest poultry companies routinely mix low levels of antibiotics into the feed given to chickens, a practice that scientists believe is especially conducive to the growth of superbugs. [Related story]

About two million people in the U.S. are sickened each year by bacterial infections that resist conventional antibiotics, and at least 23,000 people die, according to the U.S. Centers for Disease Control and Prevention. The World Health Organization called antibiotic resistance “a problem so serious it threatens the achievements of modern medicine.”

Despite such concerns, sales of antibiotics for use in food animal production rose 16 percent by volume from 2009 to 2012, government data show. Sales of cephalosporins increased at more than twice that rate.

The government has made some effort to curb ceftiofur use because of concerns about antibiotic resistance. The FDA requires farmers to obtain a prescription from a veterinarian. In 2012, the agency issued an order prohibiting most off-label uses of the drug, pointing to residues as one contributing factor.

The rise in ceftiofur use is a boon to its largest maker, Florham, N.J.-based Zoetis, the former animal drug unit of pharmaceutical giant Pfizer. Ceftiofur-based brands are the company’s top-selling line, generating about $300 million in revenue per year since 2011, according to company financial reports.

Zoetis markets its ceftiofur brands to veterinarians, who must prescribe the drug, and to farmers in YouTube videos and in veterinary and dairy publications. The drug has become one of the most popular antibiotics on American cattle farms. Veterinarians and farmers praise its potency, efficiency and ability to treat multiple ailments, from foot rot to bovine respiratory disease.

“Such a huge effect”

“We had to use so little of it for such a huge effect,” said H. Morgan Scott, a veterinary epidemiologist at Texas A+M University’s College of Veterinary Medicine.

Another selling point is the drug’s short withdrawal times. FDA withdrawal guidelines are based on the presence of antibiotic residue in meat. Compared with other antibiotics, ceftiofur is metabolized rapidly by cows — and so regulators require a shorter waiting period. The drug’s withdrawal periods are zero to three days for milk and four to 13 days for meat. With other drugs, the ranges can be four weeks or more for meat.

Those short windows leave a potential safety gap. Even when ceftiofur is used as approved, one 2007 study shows, antibiotic-resistant bacteria remained present in the guts of cattle long after the drug was given. The FDA cited the study, whose authors include Loneragan and Scott, in the 2012 order reining in use of the drug.

The study, published in the American Journal of Veterinary Research, found that one properly administered dose of a ceftiofur-based medication made by Zoetis resulted in 40 per cent of the surviving E. coli in cattle having resistance to ceftiofur six days after the dose. The resistant bacteria population remained above 20 per cent of the total for two weeks. Resistant bacteria did not return to levels typical in untreated cattle for 28 days, well after ceftiofur’s withdrawal period, the study found.

As part of the USDA’s National Residue Program, food safety regulators test meat for drugs and chemicals that could prove dangerous to consumers. In 2012, USDA tested for drug residues in about 185,000 cattle — far less than one per cent of the more than 33 million cattle slaughtered in the U.S. that year. The percentage of pigs, poultry and other animals tested is lower.

If high drug residues are found, the results are turned over to the FDA for investigation and enforcement.

In 2013, no single drug residue was found more frequently in slaughtered animals than ceftiofur, the Reuters analysis shows.

Violations involving high levels of ceftiofur in meat rose by 323 percent between 2008 and 2013 — from 98 violations to 415. Last year alone, more than a quarter of all 1,634 residue violations were for ceftiofur — more than four times its share of violations in 2008, the analysis shows. Violations involving ceftiofur have continued at a similar rate during the first half of 2014.

Dairy cows are one of America’s major sources of ground beef, which in turn is the beef product most prone to bacterial infections. Dairy cows are also the leading source of ceftiofur residues, representing 76 percent of the 415 violations in 2013. Last year, 45 percent of the 1,634 residue violations for all drugs were found in dairy cows.

Zoetis said it was aware of the residue violations but that they were small in number, and most — perhaps all — of the animals were pulled from the food supply when residues were found.

“These are animals that probably should not have gone to slaughter, or there were mistakes and animals go to slaughter that didn’t follow withdrawal periods,” said John Hallberg, director of U.S. regulatory affairs at Zoetis.

“Your bottom line”

Ceftiofur can save farmers money by keeping a cow milking longer and by preserving her value at the slaughter stage. In its marketing materials, Zoetis zeroes in on some of the savings.

In one pitch, it says that using its Excede brand instead of penicillin to treat dairy cows with bovine respiratory disease could save a farmer more than $30 per animal, after factoring in the value of milk production not lost to withdrawal.

The company makes a similar case for Excenel. “Protect your cows and your bottom line with EXCENEL,” its website says.

There are also gains to be had at life’s end. Because of the short withdrawal times, farmers can get paid more quickly after treating the animal.

“Shorter meat withdrawals. You’d have to wait 29 days longer” when using a rival drug, says an advertisement for Excede.

Time is money for a farmer with a gravely ill cow on his hands. Interviews with farmers, veterinarians and field researchers, and a review of FDA warning letters, show ceftiofur has been administered to animals by farmers eager to keep a sick animal alive long enough to sell it.

Byron, the 66-year-old retired dairyman in Kentucky, says ceftiofur is a wonder drug. It’s one of the more effective antibiotics, he found, and treated animals and their milk don’t have to be kept off market for long.

“Our attitude, most of us, was if (ceftiofur) worked, if it’ll save a cow, we’ll spend the money,” Byron said. “You’re talking about a $1,000 animal or more.”

After the USDA found high traces of ceftiofur in the cow he’d sold for slaughter, Byron received a letter from the FDA warning him to improve his processes. The agency evaluated his operation later that year, found it to be in order and closed the case. The agencies took no other action.

— Reporting for Reuters by Michael Erman in New York and Brian Grow in Atlanta. Additional reporting for Reuters by Mimi Dwyer in New York.

Ceftiofur in Canada

Ceftiofur is approved in Canada for prescription veterinary use. Specific formats and dosages are approved for the drug’s use in beef and dairy cattle, hogs, horses, sheep and dogs.

Zoetis markets the drug in Canada under the Excede, Excenel and Spectramast brand names, while Vetoquinol markets it for use in cattle under the name Ceftiocyl.

Chicken Farmers of Canada in May implemented a new policy halting the preventive use of ceftiofur and other Category I antibiotics in chicken hatcheries and on-farm for commercial meat birds.

The new CFC policy, however, exempts the use of such drugs for disease treatment when prescribed by a veterinarian. — AGCanada.com Network

The post Farmaceuticals: Powerful antibiotic for cows often misused by farmers appeared first on Farmtario.

U.S. Sen. Kirsten Gillibrand (D-NY) said she plans to introduce new legislation authorizing the Food and Drug Administration to collect data on “farm-level antibiotic use.”

The pledge was part of a letter Gillibrand sent Tuesday to FDA commissioner Margaret Hamburg. In the letter, Gillibrand said that “the scale of injudicious use” of antibiotics in poultry production documented by Reuters “was staggering.”

CLICK HERE to start reading the Reuters series.

Rep. Louise Slaughter (D-NY) urged fellow lawmakers to address the issue at a hearing on antibiotic resistance scheduled Friday before the House energy and commerce committee’s subcommittee on health.

“Industry has kept data showing the rampant, dangerous use of antibiotics hidden from the public for one reason: to protect corporate profits at the expense of public health,” Slaughter said.

Reuters reviewed more than 320 internal documents, called “feed tickets,” that detail the practices of five major companies – Tyson Foods, Pilgrim’s Pride, Perdue Farms, George’s and Koch Foods.

The feed tickets list the names and grams per ton of each “active drug ingredient” in feed. They also indicate the FDA-approved purpose of those medications, and specify during which stage in a chicken’s roughly six-week life the feed should be administered.

The documents show that antibiotics were given as standard practice over most of the life of the chickens, not just when the birds are sick. In every instance of antibiotic use identified, the doses were at the low levels that scientists say are especially conducive to the growth of so-called superbugs — bacteria that can gain resistance to conventional medicines used to treat people. Some of the antibiotics belong to categories considered medically important to humans.

In interviews, another major producer, Foster Poultry Farms, acknowledged that it also has used the antibiotics chlortetracycline and penicillin selectively but not as part of standard feed. The two drugs are in the same classes as antibiotics considered medically important to humans by the FDA.

The FDA has issued voluntary guidelines to regulate antibiotic use by producers of poultry and other livestock. The use of antibiotics rated medically important by the FDA for growth promotion is scheduled to be phased out by December 2016. The FDA says it also inspects the mills where animal feed is made but does not examine the feed tickets themselves – documents that show how drugs are administered.

In response to the Reuters report, the National Chicken Council, an industry trade group, said that the majority of antibiotics approved for use in raising chickens are not used in human medicine, and pose no threat of creating resistance.

“We understand the concern about the use of antibiotics in farm animals and recognize our responsibility to ensure they are properly used for the right reasons to protect the health of animals, humans and the food supply,” said Ashley Peterson, the council’s vice president of scientific and regulatory affairs.

Gillibrand said the legislation she intends to sponsor would enable the FDA to track farm-level antibiotic use by collecting veterinary prescriptions. Under a new FDA rule, company veterinarians will be required to issue a prescription whenever antibiotics are used. But that rule doesn’t take effect until April 2016.

Some companies are reluctant to discuss how they medicate their flocks.

In a letter dated Sept. 8, Pilgrim’s Pride advised its growers to protect “our confidential and proprietary information (information such as the information contained on feed tickets for example).” Violating what the company called “biosecurity and confidentiality obligations” is “a terminable offense” and the growers could be liable for damages, the letter said. Growers were asked to sign and date the letter.

A Pilgrim’s Pride spokesman did not respond to a request for comment.

— Brian Grow and P.J. Huffstutter report for Reuters from Atlanta ad Chicago respectively.

The post U.S. lawmakers want to curb antibiotic use on farms appeared first on Farmtario.

PART 1 OF A SERIES: Visit Part 2 and Part 3 here, or view the series in full HERE.

Internal records examined by Reuters reveal that some of the nation’s largest poultry producers routinely feed chickens an array of antibiotics — not just when sickness strikes, but as a standard practice over most of the birds’ lives.

In every instance of antibiotic use identified by Reuters, the doses were at the low levels that scientists say are especially conducive to the growth of so-called superbugs, bacteria that gain resistance to conventional medicines used to treat people. Some of the antibiotics belong to categories considered medically important to humans.

The internal documents contain details on how five major companies — Tyson Foods, Pilgrim’s Pride, Perdue Farms, George’s and Koch Foods — medicate some of their flocks.

The documented evidence of routine use of antibiotics for long durations was “astonishing,” said Donald Kennedy, a former U.S. Food and Drug Administration commissioner.

Kennedy, president emeritus of Stanford University, said such widespread use of the drugs for extended periods can create a “systematic source of antibiotic resistance” in bacteria, the risks of which are not fully understood. “This could be an even larger piece of the antibiotic-resistance problem than I had thought,” Kennedy said.

Feed tickets

Reuters reviewed more than 320 documents generated by six major poultry companies during the past two years. Called “feed tickets,” the documents are issued to chicken growers by the mills that make feed to poultry companies’ specifications. They list the names and grams per ton of each “active drug ingredient” in a batch of feed. They disclose the FDA-approved purpose of each medication. And they specify which stage in a chicken’s roughly six-week life the feed is meant for.

The feed tickets examined represent a fraction of the tens of thousands issued annually to poultry farms run by or for major producers. The confidential information they contain nonetheless extends well beyond what the U.S. government knows. Veterinary use of antibiotics is legal and has been rising for decades. But U.S. regulators don’t monitor how the drugs are administered on the farm — in what doses, for what purposes, or for how long. Made public here for the first time, the feed documents thus provide unique insight into how some major players use antibiotics.

The tickets indicate that two of the poultry producers — George’s and Koch Foods — have administered drugs belonging to the same classes of antibiotics used to treat infections in humans. The practice is legal. But many medical scientists deem it particularly dangerous, because it runs the risk of promoting superbugs that can defeat the life-saving human antibiotics.

In interviews, another major producer, Foster Poultry Farms, acknowledged that it too has used drugs that are in the same classes as antibiotics considered medically important to humans by the FDA.

About 10 per cent of the feed tickets reviewed by Reuters list antibiotics belonging to medically important drug classes. But in recent presentations, scientists with the U.S. Centers for Disease Control and Prevention said the use of any type of antibiotic, not just medically important ones, contributes to resistance. They said that whenever an antibiotic is administered, it kills weaker bacteria and enables the strongest to survive and multiply.

Frequent, sub-therapeutic use of antibiotics in low doses intensifies that effect, scientists and public health experts say. The risk: Any resulting superbugs might also develop cross-resistance to medically important antibiotics.

According to the feed tickets reviewed, low doses of antibiotics were part of the standard diet for some flocks at five companies: Tyson, Pilgrim’s, Perdue, George’s and Koch.

“These are not targeted uses aimed at specific bugs for defined duration. They’re multiple, repeat shotgun blasts that will certainly kill off weaker bugs and promote the stronger, more resistant ones,” said Keeve Nachman, director of the food production and public health program at Johns Hopkins University’s Bloomberg School of Public Health.

“Highly important” drugs

This month, Perdue Farms announced that it had stopped applying the antibiotic gentamicin to eggs in chicken hatcheries. Gentamicin is a member of an antibiotic class considered “highly important” in human medicine by the FDA. The company said it wants “to move away from conventional antibiotic use” because of “growing consumer concern and our own questions about the practice.”

The move won’t change what Perdue feeds its chickens, however. Some of its feed has contained low levels of one antibiotic, feed tickets show. Perdue said it only uses antibiotics that aren’t considered medically important by the FDA, and at some farms, it uses no antibiotics at all.

“We recognized that the public was concerned about the potential impact of the use of these drugs on their ability to effectively treat humans,” Bruce Stewart-Brown, Perdue’s senior vice president of food safety and quality, said when the hatchery policy was announced.

The poultry industry’s lobby takes issue with the concerns of government and academic scientists, saying there is little evidence that bacteria which do become resistant also infect people.

“Several scientific, peer reviewed risk assessments demonstrate that resistance emerging in animals and transferring to humans does not happen in measurable amounts, if at all,” said Tom Super, spokesman for the National Chicken Council. He said using antibiotics to prevent diseases in flocks “is good, prudent veterinary medicine. Prevention of the disease prevents unnecessary suffering and prevents the overuse of potentially medically important antibiotics in treatment of sick birds.”

Poultry producers began using antibiotics in the 1940s, not long after scientists discovered that penicillin, streptomycin and chlortetracycline helped control outbreaks of disease in chickens. The drugs offered an added benefit: They kept the birds’ digestive tracts healthy, and chickens were able to gain more weight without eating more food.

Over the years, the industry’s use of antibiotics grew. Early on, independent scientists warned that bacteria would inevitably develop resistance to those antibiotics, especially when the drugs were administered in low doses. In 1976, a landmark study by microbiologist Stuart Levy showed that potentially deadly bacteria in poultry were developing resistance to tetracyclines and other antibiotics. The resistant bacteria, E. coli, were then moving from poultry to people.

That is when the FDA first tried to rein in drug use in food animals. The agricultural and pharmaceutical industries resisted, viewing low-level antibiotic use as a way to produce meat more quickly and cheaply.

Today, 80 per cent of all antibiotics used in America are given not to people, but to livestock.

Scant review

About 390 medications containing antibiotics have been approved to treat illness, stave off disease and promote growth in farm animals. But the FDA has reviewed just seven per cent of those drugs for their likelihood of creating antibiotic-resistant superbugs, a Reuters data analysis found.

The widespread use of antibiotics worries public health authorities. In a report this year, the World Health Organization called antibiotic resistance “a problem so serious it threatens the achievements of modern medicine.” The annual cost to battle antibiotic-resistant infections is estimated at $21 billion to $34 billion in the U.S. alone, the WHO said (all figures US$).

Each year, about 430,000 people in the United States become ill from food-borne bacteria that resist conventional antibiotics, according to a July report by the CDC. Overall, the CDC estimates that two million people are sickened in the U.S. annually with infections resistant to antibiotics. At least 23,000 people die.

“That’s the number we are certain of. The actual number is higher,” said Steve Solomon, director of the CDC’s Office of Antimicrobial Resistance.

This year, federal investigators tracking a salmonella outbreak traced virulent strains of the pathogen to chickens raised by Foster Farms, the largest poultry producer on the West Coast.

Investigators identified seven strains of Salmonella Heidelberg that had sickened at least 634 people across the U.S. and Puerto Rico this year and last. More than 200 of those people were hospitalized, according to the CDC. In July, Foster Farms issued a recall of some chicken products.

When epidemiologists examined 68 of the Salmonella Heidelberg cases linked to Foster Farms, they found that two-thirds of the bacteria were resistant to at least one antibiotic, according to the CDC. Half of these superbugs were impervious to drugs in at least three different classes of antibiotics.

In an effort to stop the spread of resistant bacteria, the FDA has issued voluntary guidelines to regulate antibiotic use by producers of poultry and other livestock. The agency says it also inspects the mills where animal feed is made. It considers those inspections to be a “more effective” use of its resources than examining how farmers administer feed.

Not until 2016 does the FDA plan to gather data about antibiotic use on farms, said Craig Lewis, a veterinary medical officer with the agency. Today, “none of us have an idea first-hand of what’s going on” at the farm level, Lewis said this summer, at a public meeting on antibiotic resistance.

Super, the National Chicken Council spokesman, said the information on feed tickets “is available to FDA, the regulators, whenever they want to go see it.”

“Wake-up call”

Still, companies are reluctant to discuss how they medicate their flocks.

One, Pilgrim’s Pride, said it would take legal action against Reuters unless the news agency gave the company access to Pilgrim’s feed tickets that reporters had reviewed. Reuters declined to do so.

The tickets show that Pilgrim’s added low doses of the antibiotics bacitracin and monensin, individually or in combination, to every ration fed to a flock grown early this year. Neither drug is classified as medically important by the FDA, although bacitracin commonly is used to prevent human skin infections.

The Colorado-based company wouldn’t address questions about its use of antibiotics. Its general counsel, Nicholas White, called the contents of its tickets “confidential business information.”

U.S. Sen. Kirsten Gillibrand, D-New York, said the feed tickets substantiate what she long suspected: “that the overuse of antibiotics on many chicken farms is rampant.”

Gillibrand has been pushing for regulators to more aggressively monitor low-level doses of antibiotics. Now, Gillibrand said, she hopes “the FDA will use the feed-ticket data obtained by Reuters as a wake-up call to re-evaluate their approach to the regulation of antibiotic use in food production.”

So does Rep. Rosa DeLauro, D-Connecticut, a member of a House subcommittee overseeing food safety. Told of the information in the feed tickets, DeLauro called on the FDA to “implement tighter restrictions on antibiotic usage.”

Dual effects

All the poultry giants state publicly that they use antibiotics for the limited purpose of keeping chickens healthy.

But the feed tickets, which list the medications included in chicken feed, highlight a second effect of many of the drugs: bulking up the birds.

Some of the tickets reviewed for this article state that the antibiotics promote feed efficiency or weight gain in chickens. The FDA requires companies to list growth promotion on feed tickets whenever feed includes antibiotics that have been approved for that purpose.

Reuters found eight different antibiotics listed on the tickets it reviewed. The tickets come from a scattering of farms across the U.S. — in Mississippi, Alabama, South Carolina, Virginia and Washington State, among other locations.

George’s Inc., a poultry company based in Springdale, Arkansas, issued feed tickets last year to a chicken grower in Virginia. The tickets show that the antibiotics tylosin and virginiamycin were administered solely for “increased rate of weight gain.”

Tylosin belongs to a class of antibiotics the FDA considers “critically important” in human medicine, the most crucial of three ranks of sensitive drugs. Virginiamycin is part of a class in the FDA’s middle rank, “highly important.”

Other George’s Inc. feed tickets, given to two growers in Virginia this year, show the antibiotics bacitracin and narasin and a non-antibiotic drug called nicarbazin were included in every poultry ration in different combinations until shortly before slaughter. Bacitracin can promote growth.

George’s said in a statement: “Occasionally (when necessary to control certain pathogens) appropriate FDA approved medications are utilized to prevent, control or treat specific diseases.” It declined to answer detailed questions.

At Tyson Foods, two feed tickets sent by the company to two Mississippi farms show that bacitracin and the non-antibiotic nicarbazin were among the drugs mixed into the feed. The tickets state the drug combination is “for use in the prevention of coccidiosis in broiler flocks, growth promotion and feed efficiency.” Coccidiosis is a common intestinal ailment.

Tyson, also based in Springdale, Arkansas, said it does not use bacitracin to promote growth, only to prevent disease. The FDA requires companies to list growth promotion on tickets if medications have that effect, Tyson said. The company said that its feed mixture changes throughout the year. In some seasons, it said, the feed doesn’t include bacitracin and nicarbazin.

At Koch Foods Inc., a Chicago-based supplier to fast-food chain KFC Corp., feed tickets contradict a statement on the Koch website about antibiotic use.

Until Aug. 27, the website said Koch Foods uses antibiotics for the narrow purpose of protecting the health of its chickens. “We do not administer antibiotics at growth promotion doses,” the statement read in part. “No antibiotics of human significance are used to treat our birds.”

Koch feed tickets dated from Nov. 30, 2011, through July 20, 2014, indicate otherwise. They list low-dose amounts of five different types of antibiotics in feed given to flocks at one Alabama farm. One was virginiamycin, in a class considered “highly important” to fighting infections in humans.

In 34 of the 55 Koch Foods feed tickets that Reuters examined, antibiotics at low-dose levels were listed “for increased rate of weight gain,” a related growth-promotion use called “improved feed efficiency,” or both. Each of those feed tickets also said the antibiotics were for the prevention of coccidiosis, another bacterial infection, or both.

Koch Foods changed the website after being asked by Reuters about its use of virginiamycin. “I regret the wording mistake on that particular letter” on the website, said Mark Kaminsky, Koch’s chief financial officer. The company said it is required by the FDA to list certain drugs as growth promoters if they have that effect; Koch says it does not use them for that purpose.

Koch said it has no plans to discontinue the use of virginiamycin, which it says may be used to prevent a common intestinal infection in chicken.

KFC U.S. said in a statement: “KFC’s supply partners must adhere to our strict standards and specifications, which in some cases are more stringent than the FDA’s regulations.” A spokeswoman didn’t address detailed questions about antibiotic use by Koch Foods and KFC’s other chicken suppliers.

Healthier chickens?

The experience of one grower raises questions about whether preventive use of antibiotics has a meaningful effect on the health of chicken.

Craig Watts, who grows chicken for Perdue, says he sees little difference in outcomes for the birds he raises on feed containing an antibiotic and those he grows for the company’s antibiotic-free line.

Perdue mixes the antibiotic narasin into feed given to chickens in the company’s antibiotic-fed line. Its antibiotic-free line contains antimicrobial drugs that kill micro-organisms, but none that the FDA defines as an antibiotic, according to Perdue feed tickets shown by Watts. None of the drugs listed by Perdue on the feed tickets is considered medically important for humans.

Watts owns C+A Farms, about 20 miles north of Dillon, South Carolina. Since 2012, he has raised five antibiotic-free flocks for Perdue and seven flocks that received low doses of the antibiotic narasin, according to his records.

The mortality rates of the two flock types were nearly identical. About 900 birds died, per house, on the four-house farm. Flocks that received antibiotics and those that didn’t both hit Perdue’s target weight of about 4.25 pounds per bird.

Perdue sees “similar” performance among birds fed antibiotics and those that do not receive the drugs, said Stewart-Brown, the Perdue official overseeing food safety. “We feel our current two approaches are both very responsive to public health concerns about antibiotic use in poultry.”

Perdue still uses antibiotics in some cases, because antibiotic-free flocks are “more expensive to run and more difficult to manage effectively,” Stewart-Brown said. The production complex served by Watts’ farm recently transitioned to all antibiotic-free flocks.

Tracking an outbreak

One poultry giant whose antibiotic use has come into question is Foster Farms, based in Livingston, California. Its experience shows the difficulty of pinpointing when and how a bacteria turns into a superbug, say federal investigators.

Beginning last year, a salmonella outbreak spread across Oregon, Washington, California and 27 other states and territories. Federal investigators later linked the outbreak to chickens raised by Foster Farms and processed at a trio of its slaughterhouses in central California, according to USDA and CDC officials.

The scope of the outbreak reflected Foster Farms’ vast scale. Its operations in California’s Central Valley date to 1939, when Max and Verda Foster borrowed $1,000 against a life insurance policy and invested in an 80-acre farm.

Today, Foster owns large tracts of California farmland, chicken hatcheries in Colorado and train cars that haul grain from the Midwest. An estimated one of 10 chickens eaten in the United States is hatched, raised and slaughtered by Foster Farms, according to industry officials. The company dominates the chicken market west of the Rocky Mountains.

As the CDC studied what investigators informally called the “Foster Farms Outbreak,” researchers soon made a troubling discovery. Some of the Salmonella Heidelberg strains linked to Foster products proved resistant to a variety of antibiotics, the CDC concluded. Some of those drugs belonged to the same classes as penicillin and chlortetracycline, or CTC.

Some questions remain. Government investigators didn’t determine how the Salmonella Heidelberg traced to Foster Farms became resistant to antibiotics, and didn’t trace the resistant bacteria to specific farms. They didn’t examine Foster feed tickets from the outbreak period to see which antibiotics the company was using and how the drugs were being administered.

Reuters asked to see Foster Farms’ feed tickets from that period; the company didn’t respond to that request.

Foster Farms said it commissioned research that yielded findings very different from the CDC’s. The company declined to share the study. It summarized the research by saying scientists found no antibiotic resistance in two dozen salmonella samples collected from Foster Farms in 2012.

A CDC spokeswoman said the agency is aware that Foster Farms sponsored a study and has asked to review it, but hasn’t received a copy.

“Biology at work”

Foster Farms told Reuters it has administered CTC and penicillin at times, but selectively, not as part of standard feed. Foster said it had used CTC “as needed” to fight bacterial infections. It declined to say where or when it administered CTC. The company said it still uses penicillin to treat sick birds, but only “in critical situations when flocks are exposed to fatal diseases.” Foster doesn’t use antibiotics as growth promoters, it said.

CDC official Robert Tauxe helped investigate the outbreak. “Use of chlortetracycline could have contributed to the resistance patterns we saw” in the Salmonella Heidelberg, said Tauxe. “Penicillin, too.”

On July 11, the CDC said the Salmonella Heidelberg outbreak had ended. The USDA said it is monitoring the company’s new salmonella-prevention efforts. Agency officials and Foster’s chief veterinarian, Bob O’Connor, said the measures are working.

The company has reduced salmonella-infection rates on chicken meat from its California facilities to less than three per cent, O’Connor said, far below the national average of 25 per cent.

Despite the gains, O’Connor said the challenge of eradicating salmonella in the chicken industry remains. “For the people who wanted a silver-bullet-type story, there isn’t one,” O’Connor said. “With salmonella, we’re not going to be able to say, ‘It’s over.'”

David Acheson, a former senior medical officer for the USDA and the FDA, now serves on a food safety advisory board for Foster Farms. He said the board never examined Foster’s use of antibiotics and whether its practices could have spawned superbugs.

“Does anyone know that it happened? No. Is it possible? Could it have happened? Yes,” Acheson said. “We know that antibiotic use, irrelevant of what you are treating, whether it be human or animal, can increase the likelihood of resistance. It’s biology at work.”

— Reporting for Reuters by Brian Grow in Atlanta and Fairmont, N.C. and P.J. Huffstutter in Chicago and Livingston, California. Additional reporting for Reuters by Michael Erman and Eric Johnson.

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